Monday, May 19, 2014

How the Let’s Move! Campaign Can Become More Effective By Changing Its Values – Jomarie Polanco

           In 2010, First Lady Michelle Obama started the Let’s Move! Campaign to combat the growing obesity epidemic in children here in the United States of America. The spike in weight-related conditions in children led to Michelle Obama’s persistence for a conversation on the country’s future (5). The campaign prompted President Barack Obama to initiate the Task Force on Childhood Obesity who also came out with a report (6) in 2010 stating the different ways America, as a country, can unite to cure the obesity epidemic, especially with our children. From empowering parents and guardians to increasing physical activity to empowering school districts to change food choices in school, the Task Force on Childhood Obesity provided recommendations for the federal, private, state and local sectors as well as parents to combat the epidemic. Focusing mainly on helping parents and their children choose healthier foods, the Let’s Move! Campaign has put out many interventions are very effective interventions. They have also come out with many interventions that are not so great. A study published in JAMA in April 2014 shows that the National Health and Nutrition Examination Survey (NHANES) actually shows that obesity rates in children increased from 14.5% in 1999-2000 to 17.3% in 2011-2012 (7). Therefore the Let’s Move! Campaign interventions were not as effective as they could be. In this critique, I will be focusing on the flaws in the Healthy Eating Commercials First Lady Michelle Obama and President Barack Obama created with members of the National Basketball Association (NBA), the National Football League (NFL) and Major League Baseball (MLB). These commercials were ineffective and confusing, showing that the interventions made in collaboration with professional athletes are hurting the campaign. With a few tweaks, these commercials can help the campaign acquire its goal: to bring the obesity rates back down to what they were in 1976 by 2030 (6). The work that has been done over the past four years proves that in order to reach their highly ambitious goals, Michelle Obama and the Task Force on Childhood Obesity need more effective interventions that will instill a need for action in their targeted population.
            Even though the intentions of the Let’s Move! Campaign are incredible and an amazing amount of work has been done already in such a short period of time, such as contracts with grocery stores to open up stores in food deserts and policies instilling more healthy options in school lunches, the intervention with the professional athletes is a huge flaw in the campaign. First, it puts most of the emphasis on the athletes in the videos and not enough on the targeted population, which is also vague and inconsistent. Is it the parents or the children? The intervention uses the Theory of Planned Behavior in an ineffective way by confusing the consumer with what exactly they should eat and how exactly they should get physical activity into their daily lives. Lastly, these commercials have a flawed frame. The core of these commercials has a weak theme and is therefore not effective in communicating change. With minor but substantial changes, these commercials can be very powerful and effective in changing the minds of parents and children about healthy eating and staying physically active, and help combat the childhood obesity epidemic.
Are We Talking About the Athletes, the Children, or the Parents?
            What was most surprising in these videos was how much the athletes just talked about themselves. The questions they were asked included what is their favorite healthy summer snack/food and how do they stay active during the off-season. While these questions might have seemed like they would inherit great responses that would inspire children and parents alike to eat more like these successful, fit, active and healthy men, it does just the opposite. Instead, the athletes and coaches provide answers that prompts the viewer to think, “and that is why you are an athlete and I’m not” or “I would never/could never be able to do that!” The information portrayed through the videos is too specific to being an athlete, and the workouts specified and the food examples given are just confusing for everyone.
            The most confusing part of the videos is that it is difficult to understand to whom they are sending this message. Using professional athletes to talk to children makes sense; children look up to the people they see on television entertaining them and strive to be or be seen as them. The use of professional athletes for an intervention to children is fine. But the information we receive from the video series is too complex for children. It is not difficult to understand, but it goes beyond what they care about as children. One athlete says, “…inevitably we all end up as adults realizing that we have to make healthy choices and we have to stay active and why not get a head start on it and make that part of your lifestyle early?” (1-4). Children will not respond to that type of intervention because this is not their concern. They just want to have fun and live in the moment (8). This information would be more suited for adults, but, as we will see in more detail later, the core value given in these videos is the concept of long-term health care. People are less likely to be convinced by that value, which we have seen with many other public health interventions like in anti-smoking campaigns.
An Unsuccessful Example of the Theory of Planned Behavior
            The Theory of Planned Behavior is a theory based on individual intervention, meaning it bases its intervention on the individual rather than the community or population. Its main goal is to “pin down the relationship between people’s attitudes and their behavior” (9). The Theory of Planned Behavior notices that there is not always a connection between attitude and behavior. Therefore, people assess situations by how their behavior will be viewed by others before engaging in the activity (9). It’s foundation stems from the attitude one has towards a behavior and the subjective norms from society.  The attitude towards a behavior can stem from the belief of what would happen if they engage in the behavior and whether the outcome is good or bad. Societal pressure plays a role because what other people in the consumer’s social group will think about the behavior and the motivation to conform to the social norms also plays a huge role in the decision making process. The Theory also has a concept known as perceived behavioral control, or the idea that one has control of the behavior in question (10). Therefore, this theory argues that the targeted population will make a health behavior change because of these three ideas –
1.      The belief that this change will end with a good outcome
2.     The belief that the change will offer positive feedback from one’s social group and that the       motivation to conform to this change is received well
3.     The belief that one has the control to perform the behavior (in this case, eating healthy           and increasing physical activity).
            Just like any other theory, the Theory of Planned Behavior does have its flaws. First, it assumes that behavior happens because of a “rational, linear decision-making process” (9). It does not take into account emotions, habits, and demographic traits like culture and income. Secondly, the concept of perceived behavioral control is not very clear, especially its relevance to the decision making process (9). Lastly, the theory does not consider the time it takes between the intent to act and the actual action being taken; how does it take for the intervention to have an impact? (9)
            In this Let’s Move! intervention, the targeted population is supposed to watch these videos feel as if they can also be successful and happy by just eating right and getting in physical activity. But instead, the viewers finish the videos thinking that eating healthy is only for athletes. The intervention wants the viewer to think that following this lifestyle (i.e. eating healthy and exercising consistently) will lead to others seeing them as [insert athlete name here]. Unfortunately, it comes out as “I can become an athlete if I eat like them and do what they do. How will I procure those resources? Can I afford it?” Immediately, the intervention backfires because the essence of the videos was captured wrongly, which will be looked into in the next critique. The intervention has a lot of emphasis on an athlete’s diet and exercise regimen, excluding people who do not have those resources or are just not interested in sports or in training like an athlete. The intervention goes beyond and focuses so much on the athlete, it does not send a message to the viewers regarding healthy eating and daily physical activity.
What is in a Frame and Why This is Lacking
            The series of videos starring professional athletes bombards the viewer with just that: athletes. The information gathered and presented to the viewer is centered on being a professional athlete and what it entails. Every athlete uses the frame of long-term health to promote healthy eating and increased physical activity. This contributes to a message that makes the viewer want to reject the goal of the intervention: eat healthy and increase your physical activity. Framing a message is a way to focus on a value that is important to the consumer so that the issue becomes important in the consumer’s mind. At the same time, it can convince the consumer to be for the cause or against it, depending on how strong the argument is for either side (11). With a few symbols, phrases or images, the consumer can be presented with a certain interpretation of a topic. A frame consists of five component parts:
1.      A core position, or the argument being presented with evidence and examples for support.
2.      A metaphor, or an analogy given to support the core position and make it more relatable to the consumer.
3.     A catch phrase, or a set of words that summarizes the core position and sticks with the consumer after the intervention.
4.     Images or symbols that help the consumer visualize the core position and strengthen its value.
5.     A core value, or the reason why this is important, usually appealing to the consumer and what is widely viewed as ideal.
            Although there were many problems with the frame used in this video series, the problem that contributed the most to its ineffectiveness was the core value it chose: long-term health. If the target population of the video series were children, long-term health outcomes are the least of their worries. According to Maslow’s Hierarchy of Needs, health is a higher level of self-actualization so people are not driven to act on it (12). Especially in children, this study shows that they are focused more about immediate benefits and satisfaction, not long term (8).
            The athletes throw around the phrase “healthy lifestyle” a lot in the videos. As a catch phrase, it makes sense because that is essentially what they are supposed to be promoting. But, if the target population of these videos were children, they would have a hard time understanding how to do that. If the target population is parents and caregivers, a healthy lifestyle sounds boring and like a lot of work, which there is no time for. According to this study, adults associate “healthy lifestyle” with a negative connotation (13). The video series also uses symbols and images that don’t promote the overall core position and value of the intervention. The athletes are in suits and hanging out at the White House as if that is commonplace for them. They are eating apples constantly, and are just sitting all around the White House by themselves without their teammates. The images, especially the setting of the White House, make it look more like they want you to know this is part of the Let’s Move! Campaign and less as an intervention towards eating healthy and increasing physical activity. There are minor changes that can be done to make these videos more effective. Just by changing the core value, we can see a huge improvement in the effectiveness of this intervention.
Proposed Solution to the Health Eating Commercials Intervention
            The idea of using the Theory of Planned Behavior makes sense because when well-known figures are involved in the intervention, the idea of social norms playing into the decision-making process is ideal, especially when using figures that have a good reputation (14). I also think the intervention needs to shift more to a conversation about the children rather than the athletes. It does need to be careful of not turning into a lecture to parents, but more as a remembrance of the fun one had as a child and why parents should want the same for their children. Lastly, the framing of the message needs to change completely. Though the core position stays the same, there needs to be a metaphor involved, the catch phrases need to change to something that is appealing to children, the images need to show children that they want to change their behavior, and the values need to be important for the children and for the parents who will instill this behavioral change. With the changes ahead, this intervention could help the Let’s Move! Campaign be even more successful and a game changer in decreasing childhood obesity rates in the United States of America.
Let’s Emphasize the Children
            First, the intervention needs to change the topic to be geared towards the children and what they want to hear. The athletes should be accentuating that this behavioral change is fun and cool because that is relatable to children and adolescents (8). The children should be hearing things like, “I did this as a kid” or “I wish I did this as a kid” to really emphasize how much more fun it is to be healthy and physically active rather than sedentary.
            The videos can also show the players in action rather than in suits at the White House. If they are going to talk about being more physically active, show through imagery how active one can get. By showing the athletes working out and eating together, performing drills at the gym or on the field, and eating as a team or with their families after practice, they would be giving a much stronger message to children and parents across the nation. These videos also show Michelle Obama dressed as a First Lady. The intervention can and should incorporate the First Lady working out with the athletes and showing off what physical activity means to her, whether it is running or playing with her kids outside. What she is doing does not matter as long as she is doing it. With that, the videos can also have footage of the athletes playing with their children outside, showing parents how to promote a healthy lifestyle for their children.
An Effective Use of the Theory of Planned Behavior
            The idea to use the Theory of Planned Behavior works well for this type of intervention because of the use of well-known figures and the emphasis this theory has on social norms (14). Instead of showing children and their parents that eating healthy is only for those who want to become a professional athlete, the intervention can show that one performs better overall when living a healthy lifestyle. There should be emphasis on the athlete’s life outside of practice and games. Instead of asking questions on their favorite workouts or summer snacks, the athletes should be answering questions on what they like to do to stay active on their days off and what they like to do cook or eat with their families during the off-season. They should also be answering questions about societal pressure with eating healthy and exercising consistently in their lives. For example, a question could be, “Were you nervous or scared about what your friends would think when you became a professional athlete? Did the pressure help or hurt you?” or “What do your friends and family think about your lifestyle?” This way the athletes are answering questions in a way that is relatable to both the parents and the children watching these videos. Also, it can open up discussion for parents and their children to talk about how they can incorporate healthy living practices into their lifestyle.
Frame it to be Important Enough to Care About
            The way the videos are framed now, parents and children will not care about the implications and consequences that come from not eating healthy and exercising consistently. The idea of long-term health is not a strong core value. As humans, we tend to want immediate results; long-term results will take too long and we are impatient (15). Therefore, the core value of this intervention needs to change to something that will give parents and children an immediate sense of satisfaction. As stated before, a frame has five major components:
1.      A core position, or the argument being presented with evidence and examples for support.
2.      A metaphor, or an analogy given to support the core position and make it more relatable to the consumer.
3.     A catch phrase, or a set of words that summarizes the core position and sticks with the consumer after the intervention.
4.     Images or symbols that help the consumer visualize the core position and strengthen its value.
5.     A core value, or the reason why this is important, usually appealing to the consumer and what is widely viewed as ideal.
            My proposed framing memo for the intervention adds a metaphor and changes the phrases, images and core value –
1.      Core Position – This would stay the same. We are still saying that eating healthy and increasing physical activity is essential in living a healthy lifestyle, which has many benefits and is the essence to ending the obesity epidemic.
2.     Metaphor – The ineffective intervention didn’t have a metaphor, which may be a reason it was not relatable; there was nothing to compare what the athletes were saying. I propose a metaphor is brought in that is relatable to the children. For example, a healthy lifestyle is like studying for a test. You have to put in the work, but it is worth it when you get a good grade at the end. Living a healthy lifestyle does take time and work. It will not happen overnight, but once you start living a healthy lifestyle, the benefits of it are remarkable and worth the work and time put in.
3.     Catch Phrases – Before, the catch phrases were dull and boring and were in line with the long-term health core value. I propose changing the catch phrases to simple words that will resonate with children and their parents. Words like “fun,” “safe,” and “exciting” will stay with children and parents.
4.     Images and Symbols – I would want to change all the images and symbols from the ineffective intervention to something that is, again, more relatable to children and their parents. First, the White House setting needs to be changed with a park or field. The athletes, as well as the coaches and First Lady Michelle Obama, should be dressed in the clothes they wear to be physically active, not suits. There should be shots of players just having a great time while getting a workout. They should be laughing with each other, telling jokes, helping each other out; they are making it look like it is fun to hang out with your friends by getting your heart rate up.
5.     Core Values – The core value is the most important piece of the frame. It is the reason why the consumer should change their behavior in this case. Rather than using the weak “health” core value, the intervention should use the core value of happiness. Children will be happy running around in the mud, eating fruits and vegetables, and hanging out with friends who do the same thing. Parents will see their children have more energy and it will make them happy that their child is happy. Living a healthy lifestyle leads to a happy lifestyle.
            Changing the frame of this intervention alone would cause the most substantial change in the effect of the intervention. Just by moving to a different core value, the intervention will start to resonate with more viewers, creating a video series that changes the game in commercial consumerism.
            The solutions I proposed are only the beginning and will not help end the obesity epidemic all together. But by changing a few interventions here and there, the Let’s Move! Campaign has the skills and the resources to become the most effective and life-changing Campaign on ending childhood obesity. The public is well informed on the effects of eating poorly and living a sedentary lifestyle, but that has not stopped the increasing rates of obesity in this country. We have seen other campaigns fail using this core value of long-term health like anti-smoking campaigns and anti-drug campaigns throughout the years. The Let’s Move! Campaign should move to a labeling approach for children and their parents. It needs to show children that it is fun, cool, and part of societal norms to live a happy and healthy life. With this type of framing, the Let’s Move! Initiative will be a huge success.

References –
1. Let’s Move! Campaign YouTube Channel Video 1:https://www.youtube.com/watch?v=8Rvg8EPFqO4
2. Let’s Move! Campaign YouTube Channel Video 2: https://www.youtube.com/watch?v=CyP4LR9SDGU
3. Let’s Move! Campaign YouTube Channel Video 3: https://www.youtube.com/watch?v=eIJpmrKDh9w
4. Let’s Move! Campaign YouTube Channel Video 4: https://www.youtube.com/watch?v=oFC8M4Ms5ik
5. Let’s Move! Campaign, Website Introduction to Childhood Obesity. http://www.letsmove.gov/learn-facts/epidemic-childhood-obesity
6. White House Task Force on Childhood Obesity Report to the President. May 2010: http://www.letsmove.gov/sites/letsmove.gov/files/TaskForce_on_Childhood_Obesity_May2010_FullReport.pdf
7. Skinner AC and Skelton JA. Prevalence and Trends in Obesity and Severe Obesity Among Children in the United States, 1999-2012. JAMA Pediatrics 2014; 10.1001
8. Schlam TR, Wilson NL, Shoda Y, Mischel W, Ayduk O. Preschoolers’ delay of gratification predicts their body mass 30 years later. JAMA Pediatrics 2013; 162(1):90-3.
9. Edberg M. Individual health behavior theories (chapter 4). In: Edberg M. Essentials of Health Behavior: Social and Behavioral Theory in Public Health. Sudbury, MA: Jones and Bartlett Publishers, 2007, pp. 35-49.
10. National Cancer Institute. Theory at a Glance: A Guide for Health Promotion Practice. Part 2. Bethesda, MD: National Cancer Institute, 2005, pp. 9-21 (NIH Publication No. 05-3896). Available at: http://www.cancer.gov/PDF/481f5d53-63df-41bc-bfaf-5aa48ee1da4d/TAAG3.pdf
11. Winett L. Advocate’s guide to developing framing memos (Chapter 46). In: Iyengar S, Reeves R eds. Do the Media Govern? Politicians, Voters and Reporters in America. Thousand Oaks, CA: SAGE Publications, Inc., 1997, pp. 420-432.
12. Goble FG.  The Third Force: The Psychology of Abraham Maslow, Chapel Hill, NC: Maurice Bassett, 2004.
13. Ogle JP, Baker SS, eds. A Preliminary Study of the Meanings Children Attach to Healthy and Unhealthy Lifestyles. Journal of Extension 2007; 45(5).
14. Sridevi J. The Effect of Using Celebrities in Advertising on the Buying Decision. Research Journal of Social Science and Management 2012; 2:2.
15. Narayan J. The Psychology of Decisions to Abandon Waits for Service. Journal of Marketing Research 2011; 48(6):970-984.



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